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 i

An Introduction to Health Psychology

 iii

An Introduction to
Health Psychology

Fourth edition
Val Morrison and Paul Bennett
Pearson Education Limited
Edinburgh Gate
Harlow CM20 2JE
United Kingdom
Tel: +44 (0)1279 623623

Web: www.pearson.com/uk

First published 2006 (print)

Second edition published 2009 (print)
Third edition published 2012 (print)
Fourth edition published 2016 (print and electronic)

© Pearson Education Limited 2006, 2009, 2012 (print)

© Pearson Education Limited (print and electronic) 2016

The rights of Val Morrison and Paul Bennett to be identified as authors of this work have been
asserted by them in accordance with the Copyright, Designs and Patents Act 1988.

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ISBN: 978–1-292–00313–9 (print)

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Print edition typeset in 9.75/13 pt Times LT Pro by Lumina Datamatics, Inc.

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NOTE THAT ANY PAGE CROSS REFERENCES REFER TO THE PRINT EDITION
Contents

Preface xi
Publisher’s acknowledgements xv

PART I  BEING AND STAYING HEALTHY 1

Chapter 1 What is health? 2
Learning outcomes 2
Chapter outline 4
What is health? Changing perspectives 4
Individual, cultural and lifespan perspectives on health 12
What is health psychology? 24
Summary 29
Further reading 29

Chapter 2 Health inequalities 30

Learning outcomes 30
Chapter outline 32
Health differentials 32
Minority status and health 43
Gender and health 46
Summary 48
Further reading 49

Chapter 3 Health-risk behaviour 50

Learning outcomes 50
Chapter outline 52
What is health behaviour? 52
Smoking, drinking and illicit drug use 55
Unprotected sexual behaviour 72
Unhealthy diet 78
Obesity 81
Summary 85
Further reading 85

Chapter 4 Health-protective behaviour 86

Learning outcomes 86
Chapter outline 88
Adherence behaviour 88
vi Contents

Healthy diet 95
Exercise 99
Health-screening behaviour 108
Immunisation behaviour 116
Summary 120
Further reading 120

Chapter 5 Explaining health behaviour 122

Learning outcomes 122
Chapter outline 124
Distal influences on health behaviour 124
Models of health behaviour 131
Sociocognitive models of behaviour change 134
Stage models of behaviour change 147
Summary 156
Further reading 157

Chapter 6 Changing behaviour: mechanisms and approaches 158

Learning outcomes 158
Chapter outline 160
Developing public health interventions 160
Strategies for changing risk behaviour 162
Summary 175
Further reading 176

Chapter 7 Preventing health problems 178

Learning outcomes 178
Chapter outline 180
Working with individuals 180
Using the mass media 184
Environmental interventions 188
Public health programmes 191
Using new technology 200
Summary 203
Further reading 204

PART II  BECOMING ILL 205

Chapter 8 The body in health and illness 206
Learning outcomes 206
Chapter outline 208
The behavioural anatomy of the brain 208
The autonomic nervous system 211
The immune system 214
The digestive system 221
The cardiovascular system 225
The respiratory system 232
Summary 235
Further reading 236
 Contents vii

Chapter 9 Symptom perception, interpretation and response 238

Learning outcomes 238
Chapter outline 240
How do we become aware of the sensations of illness? 240
Symptom perception 242
Symptom interpretation 248
Planning and taking action: responding to symptoms 263
Summary 272
Further reading 272

Chapter 10 The consultation and beyond 274

Learning outcomes 274
Chapter outline 276
The medical consultation 276
Factors that influence the process of consultation 279
Moving beyond the consultation 286
Summary 298
Further reading 299

Chapter 11 Stress, health and illness: theory 302

Learning outcomes 302
Chapter outline 304
Concepts of stress 304
Types of stress 316
Stress as a physiological response 322
The stress and illness link 331
Summary 336
Further reading 336

Chapter 12 Stress and illness moderators 338

Learning outcomes 338
Chapter outline 340
Coping defined 340
Stress, personality and illness 346
Stress and cognitions 358
Stress and emotions 362
Social support and stress 364
Summary 370
Further reading 371

Chapter 13 Managing stress 372

Learning outcomes 372
Chapter outline 374
Stress theory: a quick review 374
Stress management training 375
The third wave therapies 379
Preventing stress 382
Minimising stress in hospital settings 388
Summary 391
Further reading 392
viii Contents

PART III  BEING ILL 393

Chapter 14 The impact and outcomes of illness:
patient perspective 394
Learning outcomes 394
Chapter outline 396
The impact of illness 396
Coping with illness 408
Illness and quality of life 412
Measuring quality of life 424
Summary 431
Further reading 431

Chapter 15 The impact and outcomes of illness:

families and informal caregivers 434
Learning outcomes 434
Chapter outline 436
Illness: a family affair 436
Expectancies of care 440
Family systems and family members 443
Consequences of caring for the caregiver 448
Influences on caring outcomes 452
Summary 464
Further reading 464

Chapter 16 Pain 466

Learning outcomes 466
Chapter outline 468
The experience of pain 468
Biological models of pain 472
A psychobiological theory of pain 479
Future understandings of pain: the neuromatrix 482
Helping people to cope with pain 483
Summary 492
Further reading 493

Chapter 17 Improving health and quality of life 496

Learning outcomes 496
Chapter outline 498
Coping with chronic illness 498
Reducing distress 499
Managing illness 504
Preventing disease progression 512
Summary 517
Further reading 517
 Contents ix

PART IV  FUTURES 519

Chapter 18 Futures 520
Learning outcomes 520
Chapter outline 522
The need for theory-driven practice 522
Getting evidence into practice 525
Summary 534
Further reading 534

Glossary 535
References 547
Index 642

Supporting resources
Companion website
For open-access student resources specifically written to complement this textbook
and support your learning, please visit www.pearsoned.co.uk/morrison

Lecturer resources
For password-protected online resources tailored to support the use of this textbook in
teaching, please visit www.pearsoned.co.uk/morrison
This page intentionally left blank

Preface
Background to this book
Well, it’s that time again . . . time to bring out another
edition of the book. As always, this time provides an
opportunity to update, revise and generally ‘improve’ the
text. And this edition certainly achieves these goals. It is
not just an update on previous editions, but has a number
of significant revisions, reflecting changes in emphasis in
both the practice of health psychology and its developing
research base. Despite these changes, we remain true to
our original goal and beliefs. We believe health psychol-
ogy is an exciting and vibrant discipline to study at both
undergraduate and postgraduate level. It has developed
into an exciting professional discipline with a defined
training pathway and increasing numbers of relevant jobs
both in health-care systems and other contexts.
We wrote the first edition of the book because we
believed that a comprehensive European-focused text-
book was required that didn’t predominantly focus on
health behaviours, but gave equal attention to issues in
health, in illness, and in health-care practice and interven-
tion. In addition, we believed that health-care training
textbooks should be led by psychological theory and
constructs, as opposed to being led by behaviour or by
disease. Diseases may vary clinically, but, psychologically
speaking, they share many things in common; the poten-
tial for life or behaviour change, distress and emotional
growth, challenges to coping, potential for recovery,
involvement in health care and involvement with health
professionals. We stick to this ideology; as clearly do
many other people, because we have been asked to
produce this fourth edition. We have maintained our com-
prehensive coverage of health, illness and health care,
while updating and including reference to significant new
studies, refining some sections, restructuring others, and
basically working towards making this new edition dis-
tinctive and (even) stronger than the last! Our readership
includes many medical students and therefore we have
Preface xi
integrated several case studies to bring the human and
clinical perspective even more to life.
Aims of this textbook
The overall aim of this textbook is to provide a balanced,
informed and comprehensive UK/European textbook
with sufficient breadth of material for introductory stu-
dents, but which also provides sufficient research depth
to benefit final year students or those conducting a
health psychology project including at Masters level. In
addition to covering mainstream health psychology top-
ics such as health and illness beliefs, behaviour and
outcomes, we include topics such as socio-economic
influences on health, biological bases, individual and
cultural differences, the impact on family and carers, and
psychological interventions in health, illness and health
care, as these are all essential to the study of health
psychology.
In this edition, we have stuck to a format in which
chapters follow the general principle of issue first, theory
second, research evidence third, and finally the
­application of that theory and, where appropriate, the
effectiveness of any intervention. We first examine factors
that contribute to health, including societal, cognitive,
emotional and behavioural factors, and how psycholo-
gists and others can improve or maintain individuals’
health. We then examine the process of becoming ill:
from the first perception of symptoms through their
­interpretation and presentation to health care. We exam-
ine the physiological systems that may fail in illness,
psychosocial factors that may contribute to the develop-
ment and impact of illness, how we and our friends and
families cope with illness, and how the medical system
copes with us when we become ill. Finally, we examine a
number of psychological interventions that can improve
the well-being and p ­ erhaps even health of those who
experience health problems.
xii Preface
This text is intended to provide comprehensive cover-
age of the core themes in current health psychology but
it also addresses the fact that many individuals neither
stay healthy, nor live with illness, in isolation. The role of
family is crucial and therefore while acknowledging the
role of significant others in many chapters, for example in
relation to influencing dietary or smoking behaviour, or in
providing support during times of stress, in this 4th edi-
tion we devote all of Chapter 15 to the impact of illness
on the family and caregivers of people who are ill.
Another goal of ours in writing this textbook was to
acknowledge that Western theorists should not assume
cross-cultural similarity of health and illness perceptions
or behaviours. Therefore from the first edition to this cur-
rent edition we have integrated examples of theory and
research from non-Westernised countries wherever pos-
sible. Throughout this text runs the theme of differentials,
whether culture, gender, age/developmental stage, or
socio-economic, and, as acknowledged by reviewers
and readers of the first three editions, our commitment to
this is clearly seen in the inclusion of a whole chapter
devoted to socio-economic differentials in health.
Structure of this textbook
Key changes from earlier editions of this book include
greater consideration of personality and cultural influences
on health behaviour in Chapters 3–5, and the addition of a
chapter focusing completely on theories and mechanisms
of behavioural change. These developments are reflected
in Chapter 6 of the new edition which is now devoted
entirely to exploring the nature of these behavioural
change strategies and the theories from which they are
derived. Chapter 7 then considers how these strategies
can be used in preventing disease both through working
with individuals and at a population level. In terms of the
chapters addressing the illness experience, in chapter 14
we now consider the impact of illness on a range of out-
comes directly impacting on the individual affected, while
Chapter 15 is now devoted to the impact on the family and
caregivers of these individuals. Chapter 17 considers the
implementation of strategies of change or emotional regu-
lation in people who have already developed disease. In
addition to these structural changes, we have incorpo-
rated more discussion of health psychology in the context
of younger people and more qualitative research.
The textbook continues to be structured into three
broad sections. The first, Being and Staying Healthy,
contains seven chapters, which first examine factors that
contribute to health, including societal and behavioural
factors, and then describe how psychologists and others
can improve or maintain individuals’ health. Chapter 1
considers what we actually mean when we talk about
‘health’ or ‘being healthy’ and presents a brief history to
the mind–body debate which underpins much of our
research. We consider the important influence of current
health status, lifespan, ageing and culture on health, and
in doing so illustrate better the biopsychosocial model
which underpins health psychology. Chapter 2 describes
how factors such as social class, income and even post-
code can affect one’s health, behaviour and access to
health care. Indeed, the health of the general population
is influenced by the socio-economic environment in
which we live and which differs both within and across
countries and cultures. We have tried to reflect more of
this diversity in the present volume.
Many of today’s ‘killer’ illnesses, such as some can-
cers, heart disease and stroke, have a behavioural com-
ponent. Chapters 3 and 4 describe how certain
behaviours such as exercise have health-enhancing
effects whereas others, such as non-adherence to
medicines, smoking or the use of illicit drugs, have
health-damaging effects. More detail has been added
regarding two groups of behaviours – over-eating, and
illicit drug use. As well as updating the epidemiological
statistics regarding such health behaviours and outlining
current health policy and targets where they exist, we
continue to provide evidence of individual, lifespan, cul-
tural and gender differentials in health behaviours. These
behaviours have been examined by health and social
psychologists over several decades, drawing on several
key theories such as social learning theory and socio-
cognitive theory. In Chapter 5 we describe several mod-
els which have been rigorously tested in an effort to
identify which beliefs, expectancies, attitudes and nor-
mative factors contribute to health or risk behaviour.
More coverage of adherence behaviour has been added
as has greater discussion of some of the broader deter-
minants of behaviour. This chapter has also been
reworked to provide students with the opportunity for
more critical reflection. This section of the book, there-
fore, presents evidence of the link between behaviour
and health and illness, and highlights an area where
health psychologists have much to offer in terms of
understanding or advising on individual factors to target
in interventions. The section ends with two chapters on
intervention. Chapter 6 now focuses entirely on theories
of behavioural change, while Chapter 7 considers how
these may be applied, and with what success in inter-
ventions designed to prevent people developing illness
and poor health. It addresses interventions targeted at
both individuals and whole populations, in a strategy
known as public health intervention.

The second section, Becoming Ill, contains six chap-
ters which take the reader through the process of
becoming ill: the physiological systems that may fail in
illness, the psychosocial factors that may contribute to
symptom perception, and report and how we communi-
cate with the medical system. We start with a whole
chapter dedicated to describing biological and bodily
processes relevant to the physical experience of health
and illness (Chapter 8). In this fourth edition, this chapter
covers a broader range of illnesses as well as some
­individual case study examples and more signposts to
relevant psychological content to be found elsewhere in
the book. Chapter 9 describes how we perceive, inter-
pret and respond to symptoms, highlighting individual,
sociocultural and contextual factors that influence the
process of health-care-seeking behaviour, including the
use of lay and online referral systems (how many of us
have not ‘googled’ our symptoms at some point?), and
has seen general updating in order that the increasing
number of studies addressing medically unexplained
symptoms (MUS) are addressed and that studies of the
dynamic and changing nature of illness perceptions and
responses which more fully address the underlying theo-
retical assumptions are covered. In Chapter 10 present-
ing to, and communicating with, health professionals is
reviewed with illustrations of ‘good’ and ‘not so good’
practice. The role of patient involvement in decision-
making is an important one in current health policy and
practice, and the evidence as to the benefits of patient
involvement is reviewed here. The chapter also considers
how health practitioners arrive at clinical decisions under
time pressure and information poverty: and why they
sometimes get them wrong.
Chapters 11 and 12 take us into the realm of stress,
something that very few of us escape experiencing from
time to time! We present an overview of stress theories,
where stress is defined either as an event, a response or
series of responses to an event, or as a transaction
between the individual experiencing and appraising the
event, and its actual characteristics. We also focus on
aspects of stress beyond the individual, with considera-
tion of occupational stress, and how stress impacts on
health through consideration of the growing field of psy-
choneuroimmunology. In both this and the subsequent
chapter greater consideration of gender, personality and
lifespan issues are included. Chapter 12 presents the
research evidence pertaining to factors shown to ‘moder-
ate’ the potentially negative effect of seemingly stressful
events, from distal antecedents such as socio-economic
resources, social support and aspects of personality
which we have increased coverage of (e.g. optimism,
conscientiousness), to specific coping styles and
Preface xiii
s­ trategies. We also include a more positive view of stress
and well-being, focusing on the concepts of ‘positive
psychology’. In fact, positive beliefs become a recurring
theme and also arise in Chapters 14 and 15. Chapter 13
turns to methods of alleviating stress, where it becomes
clear that there is not one therapeutic ‘hat’ to fit all, as we
describe a range of cognitive, behavioural and cognitive-
behavioural approaches. The increasingly valued concept
of mindfulness and mindfulness-based interventions is
also introduced.
In the third section, Being Ill, we turn our attention to
the impact of illness on the individual and their families
across two chapters. Chapter 14 is devoted to the impact
of illness on the ill individual, focusing on both negative
and positive outcomes. Perhaps unique to this textbook,
is a whole chapter, Chapter 15, devoted to the impact of
providing care for a sick person within the family. This
fourth edition further highlights research that considers
the dyad (patient–spouse most typically) demonstrating
how such studies can add to our understanding of illness
experiences and health outcomes. Chapter 16 addresses
a phenomenon that accounts for the majority of visits to a
health professional – pain – which has been shown to be
much more than a physical experience. This chapter is
the only disease-specific chapter in our text, but we
chose to contain a chapter on pain and place it at this
point towards the end of our book because, by illustrating
the multidimensional nature of pain, we draw together
much of what has preceded (in terms of predictors and
correlates of illness, health-care processes, etc.). Pain
illustrates extremely well the biopsychosocial approach
health psychologists endeavour to uphold. In a similarly
holistic manner, Chapter 17 looks at ways of improving
health-related quality of life by means of interventions
such as stress management training, the use of social
support, and illness management programmes.
Finally, we close the fourth edition of this text in the
same way we closed the first, with Chapter 18, which we
have called Futures. This chapter has changed signifi-
cantly over time in that it now has three key foci: (i) how
a number of psychological theories can be integrated to
guide psychological interventions, (ii) how the profession
of health psychology is developing in a variety of coun-
tries and the differing ways it is achieving growth, and
(iii) how psychologists can foster the use of psychological
interventions or psychologically informed practice in
areas (both geographical and medical) where they are
unused. This ends our book therefore by highlighting
areas where health psychology research has or can per-
haps in the future, ‘make a difference’.
We hope you enjoy reading the book and learn from it
as much as we learned while writing it. Enjoy!
xiv Preface
Acknowledgements
This project has been a major one which has required the
reading of literally thousands of empirical and review
papers published by health, social and clinical psycholo-
gists around the globe, many books and book chapters,
and many newspapers to help identify some hot health
issues. The researchers behind all this work are thanked
for their contribution to the field.
On a more personal level, several key researchers and
senior academics also acted as reviewers for our chap-
ters, some of whom have been with us from the first
edition and have shown great commitment and forbear-
ance! At each stage they have provided honest and
constructive feedback and their informed suggestions
have made this a better book than it might otherwise
have been! They also spotted errors and inconsistencies
that are inevitable with such a large project, and took
their role seriously.
Many thanks also to the indomitable editorial team at
Pearson Education, with several development editors
having taken their turn at the helm and guided us through
a few bad patches where academic demands and our
own research prevented us from spending time on ‘the
book’. Particular thanks go to Lina Aboujieb who has
been indomitable in her support and has pushed, pulled,
advised and cajoled us up to the point where we hand
over to the production team.
Paul Bennett and Val Morrison
June 2015
Publisher’s
acknowledgements
We are grateful to the following for permission to repro-
duce copyright material:
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Professor Sir John Arbuthnott, principal and vice-chan-
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sion from Elsevier; Figure 14.2 adapted from Turning the
tide: benefit finding after cancer surgery, Social Science
and Medicine, 59, pp. 653 – 62 (Schulz, U. and Mohamed,
N.E., 2004), with permission from Elsevier; Figure 14.3
from Quality of life: a process view, Psychology and
Health, 12, pp. 753 – 67 (Leventhal, H. and Coleman,
S. 1997), with permission from Taylor & Francis; Figure
15.1 from Chronic illness and the life cycle: a conceptual
framework, Family Process, 26(2), pp. 203–21 (Rolland,
J.S., 1987), John Wiley & Sons, Inc.; Figure 15.2 from In-
terpersonal emotional processes in adjustment to chronic
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K.R. (J. Suls and K.A. Wallston (eds)) 2003), Blackwell, re-
produced with permission of Blackwell Publishing; Figure
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trial, Thorax, 67, pp. 769–76 (Pbert, L., Madison, J.M.,
Druker, S. et al., 2012), with permission from BMJ Pub-
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Table 1.1 adapted from World Health Statistics, WHO
(2013), World Health Organization; Table 1.2 adapt-
ed from Health at a Glance: Europe 2012, OECD
(2012) p. 21, OECD Publishing, Paris, http://dx.doi.
org/10.1787/9789264183896-en; Table 2.1 adapted
from Global Recommendations on Physical Activity for
Health, WHO (2013), World Health O ­ rganization; Table 3.1
from Global Health Risks: M ­ ortality and Burden of Dis-
ease Attributable to Selected Major Risks, WHO (2009)
p. 11, World Health Organization; T ­able 3.2 from Sen-
sible Drinking Guidelines, http://www.drinkingandyou.
com/site/pdf/Sensibledrinking.pdf, Alcohol in Moderation;
­Table 3.3 from The 1971 The Misuse of Drugs Act, HMSO
(1971), contains public sector information licensed under
the Open Government Licence (OGL) v3.0, http://www.
nationalarchives.gov.uk/doc/open-government-licence;
Table 3.4 from HIV/AIDS Surveillance in Europe reports,
http://ecdc.europa.eu/en/healthtopics/aids/surveillance-
reports/Pages/surveillance-reports.aspx, © European
Centre for Disease Prevention and Control (ECDC); Table
4.1 from Global Recommendations on Physical ­Activity
for Health, WHO (2010), World Health Organization; Ta-
ble 4.2 adapted from Health at a Glance: Europe 2012,
OECD (2012) p. 107, OECD Publishing, Paris, http://
dx.doi.org/10.1787/9789264183896-en; Table on p. 174
adapted from Does theory influence the effectiveness
of health behavior interventions? Meta-analysis, Health
Psychology, 33(5), pp. 465–74 (Prestwich, A., Sniehotta,
F.F., Whittington, C., Dombrowski, S.U., Rogers, L. and
Michie, S., 2014), American Psychological Association,
reprinted with permission; Table 7.2 from Effectiveness
analysis on the physical activity and the health benefit of
a community population based program, Biomedical and
Environmental Sciences, 26(6), pp. 468–73 (Jiang, Y.Y.,
Yang, Z.X., Ni, R., Zhu, Y.Q., Li, Z.Y., Yang, L.C., Zhai,
Y. and Zhao, W.H., 2013), with permission from Elsevi-
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physical activity intervention: a randomized controlled trial,
­American Journal of Preventive Medicine, 43(5), pp. 527–
32 (­Cavallo, D.N., Tate, D.F., Ries, A.V., Brown, J.D., DeV-
ellis, R.F. and Ammerman, A.S., 2012), Elsevier, Inc.; Table
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and Rahe, R.H. 1967), Elsevier, Inc.; Table 11.2 adapted
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tional model, British Journal of Health Psychology, 18, pp.
97–121 (Hulbert-Williams, N.J., Morrison, V., Wilkinson,
C. and Neal, R.D., 2013), reproduced with permission of

Blackwell Publishing; Table 11.3 adapted from Stress and
Health, Brooks/Cole (Rice, P.L., 1992) pp. 188–92, Cen-
gage Learning, Inc.; Tables on pp. 387 and 388 adapted
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work factors among healthcare professionals in a hospital
setting, Occupational and Environmental Medicine, 68,
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Table 14.1 from EORTC QLQ-C30, http://groups.eortc.
be/qol/eortc-qlq-c30, EORTC Quality of Life, for permis-
sion to use contact: Quality of Life Department, EORTC
European Organisation for Research and Treatment of
Cancer, AISBL-IVZW, Avenue E. Mounier, 83/11, 1200
Brussels, Belgium, website: http://groups.eortc.be/qol;
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Rosenberg-Yunger, Z.R., Watt, L., Sung, L., Klaassen, R.,
Dix, D. and Shaw, N.T., 2012), with kind permission from
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stan Veterans with comorbid chronic pain and posttrau-
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opment, 51(4), pp. 559–70 (Outcalt, S.D., Ang, D.C., Wu,
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tocol for delivering bad news: application to the patient
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women to suffer the pain of a natural birth’, says medical
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right Guardian News & Media Ltd, 2015.
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 1

Part I
Being and staying
healthy
Another random document with
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feeling whose influence, had he lived, promised to make for
whatever was noble and good.
 A LARGE BRAIN AND A LARGE HEART.

From the “Elmira, N.Y., Advertiser.”

Throughout the entire North as well as in the South will there be
heartfelt and sincere mourning over the death of this most
distinguished editor on the other side of Mason and Dixon’s line. It
was only ten days ago that he came North and delivered an address
at the annual dinner of the Merchant’s Club of Boston, following it on
the next evening with a speech before the Bay State Club, a
Democratic organization. While on this trip Mr. Grady contracted a
severe cold which was the immediate cause of his death yesterday
morning.
The dead editor was a man of large brain and large heart. His
hope was in the future of the South and he worked for the results
which his prophetic ken perceived ahead of its present with great
earnestness and great judgment. Since he became the editor of the
Atlanta Constitution he has labored unceasingly to remedy the
unfortunate conditions which operated against the progress and
development of the South. Under his inspiring leadership and wise
counsel many enterprises have been started and encouraged. There
is no other one man to whom the New South owes so much as to
Henry W. Grady. When he came to New York City two years ago,
and in a notable address there told the people what this New South
had done and was trying to do, the public was astonished at his
statistics. The speech was so eloquent, so earnest, so broadly
American in tone and spirit that it attracted wide attention and sent a
thrill of admiration to the heart of every gratified reader. It made him
not only famous but popular all through the North. This fame and
popularity were increased by his recent excellent addresses in
Boston. The Advertiser published, on Thursday last, on the fourth
page, an extract from one of these speeches, entitled “The Hope of
the Republic,” and we can do the dead man no better honor than to
recommend to our readers that they turn back and read that extract
again. It expresses the purest sentiment and highest appreciation of
the foundation principles of the Republic.
Mr. Grady was a Democrat and a Southern Democrat. Yet he was
a protectionist and believed that the development of the South
depended upon the maintenance of the protective tariff. Under it the
iron manufactures and various products of the soil in that section of
our country have been increased to a wonderful extent while the
general business interests have strengthened to a remarkable
degree. Mr. Grady has encouraged the incoming of Northern
laborers and capitalists and aided every legitimate enterprise. He
has been a politician, always true to his party’s candidates, though
he has been somewhat at variance with his party’s tariff policy. He
has been a good man, a noble, true Christian gentleman, an earnest,
faithful editor and a model laborer for the promotion of his people’s
interests.
 THE MODEL CITIZEN.

From the “Boston Globe.”

Henry W. Grady dead? It seems almost impossible.
Only ten days ago his fervid oratory rang out in a Boston banquet
hall, and enchanted the hundreds of Boston’s business men who
heard it. Only nine days ago the newspapers carried his glowing
words and great thoughts into millions of homes. And now he lies in
the South he loved so well—dead!
“He has work yet to do,” said the physician, as the great orator lay
dying. “Perhaps his work is finished,” replied Mr. Grady’s mother.
She was right. To the physician, as to many others, it must have
seemed that Mr. Grady’s work was just beginning; that not much had
yet been accomplished. For he was young; only thirty-eight years
old. He had never held a public office, and there is a current delusion
that office is the necessary condition of success for those endowed
with political talents. But Mr. Grady had done his work, and it was a
great work, too. He had done more, perhaps, than any other man to
destroy the lingering animosities of the war and re-establish cordial
relations between North and South. His silvery speech and graphic
imagery had opened the minds of thousands of influential men of the
North to a truer conception of the South. He had shown them that
the Old South was a memory only; the New South a reality. And he
had done more than any other man to open the eyes of the North to
the peerless natural advantages of his section, so that streams of
capital began to flow southward to develop those resources.
He was a living example of what a plain citizen may do for his
country without the aid of wealth, office or higher position than his
own talents and earnest patriotism gave him.
Boston joins with Atlanta and the South in mourning the untimely
death of this eloquent orator, statesmanlike thinker, able journalist
and model citizen. He will long be affectionately remembered in this
city and throughout the North.
 A LOYAL UNIONIST.

From the “Chicago Times.”

Mr. Grady was a loyal Unionist. The son of a Union veteran,
proud of his sire’s part in the battle-fields of the rebellion, could not
be more so. He stood manfully against the race prejudice which
would lash the negro or plunder or terrorize him, but he recognized
fully the difficulties of the race problem, and would not blink the fact,
which every Northern man who sojourns in the South soon learns,
that safety, progress, peace, and prosperity for that section forbid
that the mere numerical superiority of the blacks should authorize
them to push the white man, with his superior capability for affairs,
from the places where laws are made and executed. Mr. Grady
looked upon the situation dispassionately and told the truth about it
to Northern audiences.
He was an active force in the journalism of the South, where the
journal is still regarded largely as an organ of opinion and the
personality of the editor counts for much. He entered the newspaper
field when the modern idea of news excellence had obtained a full
lodgment at the North and at one or two places South of the Ohio,
and while he loved to occupy the pulpit of the fourth page he was not
unmindful of the demand for a thorough newspaper.
 HIS WORK WAS NOT IN VAIN.

From the “Cleveland, O., Plaindealer.”

The death of Henry W. Grady of the Atlanta Constitution is a loss
to journalism, to the South and to the nation. He had done good work
for each, and still more could reasonably be expected of him but for
his untimely death at the comparatively early age of thirty-eight. His
fatal illness was contracted when serving the cause of the whole
country by pleading in the North for a more generous and just
judgment of the Southern people and of their efforts to solve the race
problem. He has done much toward bringing about a better
understanding by his brilliant, earnest and logical addresses to
Northern audiences, in which he abated nothing of that intense love
for that part of the Union of which he was a native, but at the same
time appealed to them as citizens of the same country, as brothers,
to bury past differences, make allowance for conditions that were not
desired and could not be avoided, and substitute friendly confidence
for prejudiced suspicion. More of the same good work was expected
of him, but as his mother said when speaking of his dangerous
condition: “May be his work is finished.” Under his management the
Constitution worked unceasingly for the physical and moral
regeneration of the South. It preached the gospel of the “New
South,” redeemed by work, by enterprise and by devotion to the
Union of which the South is an integral part, and its preaching has
not been in vain. With pen and tongue, equally eloquent with both,
Mr. Grady labored in behalf of the cause he had so much at heart,
and, although dying thus early, he had the satisfaction of knowing
that his work was not in vain; that it is certain to bring forth good fruit.
 THE BEST REPRESENTATIVE OF THE NEW SOUTH.

From the “Albany, N.Y., Journal.”

By the death of Henry Woodfin Grady the country loses one of its
most brilliant journalists.
Throughout the country his death will be deplored as most
untimely, for the future was bright before him. He had already,
although only thirty-eight years old, reached the front rank in his
profession, and he had been talked of as nominee for the vice-
presidency. This eminence he won not only by his brilliant writing,
but also by his integrity and high purposes. He never held an office,
for though he could make and unmake political destinies, he never
took for himself the distinctions he was able to bestow upon others.
Though he inherited many ante-bellum prejudices and feelings, yet
no editor of the South was more earnest, more fearless in
denouncing the outrages and injustices from time to time visited
upon the negro. So the American people have come to believe him
the best representative of the “New South,” whose spokesman he
was—an able journalist and an honest man who tried according to
his convictions to make the newspaper what it should be, a living
influence for the best things in our political, industrial and social life.
 A LAMENTABLE LOSS TO THE COUNTRY.

From the “Cincinnati Commercial Gazette.”

He was a man of high faculties and purposes, and of great breadth
of sympathy. He had courage of heart equal to capacity of brain, and
placed in the core of the South, in her most busy city, and the
undoubted representative man of her ambition and progress, it is
lamentable that he should be lost to the country.
It seemed to be in no man’s grasp to do more good than he had
appointed for his task. He has done that which will be memorable. It
is something forever, to plow one deep furrow in fertile land for the
seed that is in the air.
He is dead, as the poets that are loved must die, still counting his
years in the thirties; and there is this compensation, that it may yet
be said of him in the South, as was so beautifully sung by Longfellow
of Burns in Scotland, that he haunts her fields in “immortal youth.”

And then to die so young, and leave

Unfinished what he might achieve.
... He haunts his native land
As an immortal youth; his hand
Guides every plow,
He sits beside each ingle-nook;
His voice is in each rushing brook,
Each rustling bough.
 A SAD LOSS.

From the “Buffalo, N.Y., Express.”

The death of no other man than Henry Woodfin Grady could have
plunged Georgia into such deep mourning as darkens all her borders
to-day. Atlanta is the center of Georgia life, and Grady was the
incarnation of Atlanta vitality. His was a personality difficult to
associate with the idea of death. He was so thoroughly alive, bodily
and mentally, he was so young, the fibers of his being reached out
and were embedded in so many of the living interests of Georgia and
the whole South, that no thought of his possible sudden end would
rise in the minds of any who knew him. And his friends were legion.
Everybody called him Henry.
In ten years he rose from obscurity to a prominence that made him
the foremost figure of his day in the South, and had already linked
his name with the second office in the gift of the American people.
As an orator he was the pride of the South, as Chauncey M. Depew
is of the North. As a journalist no Northern man bears the relation to
his section that Grady did to the South. As a public-spirited citizen it
seemed only necessary for Grady to espouse a project for it to
succeed beyond all expectations. Yet but a few years ago he started
three newspapers in succession and they all failed! Failure was the
alphabet of his success.
When Mr. Grady bought a quarter interest in the Atlanta
Constitution he had had but slender training in journalism. He had
written a great deal, which is quite another thing. Though the
Constitution has remained intensely provincial in its methods ever
since, he has given it an influence in the South unrivalled by any
other paper, with possibly one exception. Under his inspiration the
Constitution viewed everything Georgian, and especially Atlantian,
as better than similar things elsewhere. It backed up local
enterprises with a warmth that shames the public spirit of most
Northern cities. It boasted of local achievements with a vehemence
that was admirable while it sometimes was amusing. Florid in his
own speech and writing, Mr. Grady gathered about him on the
Constitution men of similar gifts, who often wrote with pens dipped,
as it were, in parti-colored inks, and filled its columns with ornate
verbal illuminations. Yet amid much that was over-done and under-
done there often appeared work of genuine merit. For the
Constitution under Grady has been the vehicle by which some of the
most talented of the late Southern writers have become familiar to
the public. Grady was proud of them, and of his paper. “I have the
brightest staff and the best newspaper in the United States,” he once
remarked to this writer. And Mr. Grady firmly believed what he said.
It was as a speech-maker that Grady was best known at the North.
Echoes of his eloquence had been heard here from time to time, but
soon after the Charleston earthquake he made the address on “The
New South,” before the New England Society at New York, that won
for him the applause of the entire country, and must now stand as
the greatest effort of his life. His recent speech in Boston is too fresh
in mind to need attention here. Mr. Grady’s style was too florid to be
wholly pleasing to admirers of strong and simple English. He dealt
liberally in tropes and figures. He was by turns fervid and pathetic.
He made his speeches, as he conducted his newspaper, in a
manner quite his own. It pleased the people in Georgia, and even
when he and his partner, Capt. Howell, ran the Constitution on both
sides of the Prohibition question it was regarded as a brilliant stroke
of journalistic genius.
Personally Mr. Grady was one of the most companionable and
lovable of men. His hand and his purse were always open. His last
act in Atlanta, when waiting at the depot for the train that bore him to
the Boston banquet, was to head a subscription to send the Gate
City Guard to attend Jefferson Davis’s funeral. His swarthy face was
lighted by a bright, moist, black eye that flashed forth the keen,
active spirit within. The impression left upon the mind after meeting
him was of his remarkable alertness.
He will be a sad loss to Georgia, and to the South. There is none
to take his place. His qualities and his usefulness must be divided
henceforth among a number. No one man possesses them all.
 WORDS OF VIRGIN GOLD.

From the “Oswego, N.Y., Palladium.”

The peaceful serenity of the Christmas festival is sadly married by
the intelligence flashed over the wires from the fair Southern city of
Atlanta to-day. “Death loves a shining mark,” and without warning it
came and took away Henry W. Grady, the renowned orator and the
brilliant editor, the man above all others who could least be spared
by the South at this time. A week ago last Thursday night he stood
up in the banquet hall at Boston and with charming eloquence
delivered to the people of the North a message from the loyal South
—a message that went out over the land and across the sea in
words of pure, virgin gold, that will live long after he from whose lips
they fell has returned to dust. Mr. Grady’s effort on that occasion
attracted the admiration of the whole country. He spoke as one
inspired, and his pathetic words at times moved strong men to tears
and made a lasting impression upon all who were privileged to hear
him. When he resumed his seat exhausted and perspiring, he
became a prey to the chilling draughts and took a very severe cold.
The evening next following he was banqueted by the Bay State Club
of Boston, and when he arose to respond to a happy sentiment
offered by the toastmaster in honor of the guest of the evening, he
could scarcely speak. He apologized for his condition and spoke but
briefly, and when he had finished the company arose and gave him a
double round of cheers. Among the fine sentiments of his closing
words, the last of his public utterances, were these: “There are those
who want to fan the embers of war, but just as certain as there is a
God in the heaven, when these uneasy insects of the hour perish in
the heat that gave them life, the great clock of this Republic will tick
out the slow moving and tranquil hour and the watchmen in the
street will cry, ‘All is well! All is well!’” His last words were these: “We
bring to your hearts that yearn for your confidence and love, the
message of fellowship from our home, and this message comes from
consecrated ground—ground consecrated to us by those who died in
defeat. It is likely that I shall not again see Bostonians assembled
together, therefore I want to take this occasion to thank you and my
excellent friends of last night, and those friends who accompanied us
this morning to Plymouth, for all that you have done for us since we
have been here, and to say that whenever you come South, just
speak your name and remember that Boston and Massachusetts is
the watchword, and we will meet you at the gate.”
Mr. Grady returned home immediately, and his friends, who had
prepared to greet him with a great reception, met him at the train
only to learn that he was sick unto death. He was carried home
suffering with pneumonia and at 3:40 A.M. to-day breathed his last.
The nations will stop amid the Christmas festivities to lay upon the
bier of the dead Southerner a wealth of tenderness and love.
It was as an editor that Grady was best known. His brilliant and
forceful contributions made the Atlanta Constitution famous from one
end of this broad land to the other. As an orator he was master of an
accurate and rhythmical diction which swept through sustained
flights to majestic altitudes. We will deal with the statistical record of
his life at another time, and can only add here that it is a matter for
sincere regret that he has been taken away before he had reached
the summit of his fame or the meridian of his usefulness.
 SAD NEWS.

From the “Boston Advertiser.”

The untimely death yesterday of Henry Woodfin Grady is sad
news. He was predisposed to lung diseases, and the circumstances
of his visit to Boston were most unfortunate. The weather was very
mild when he arrived here, but became suddenly chill and wintry just
before his departure. Half our native population seemed to have
caught cold owing to the sudden and severe change in temperature,
and Mr. Grady contracted pneumonia in its most violent form, so that
he grew steadily worse to the end. His trip to Boston was eagerly
anticipated, both because he had never been in New England, and
also for the reason that the greatest interest had been created both
North and South over the announcement that he would speak on the
race problem. The impression made by his address—for it rose far
above the ordinary after-dinner speech—is still strong, and the
expectation created in the South is attested by the fact that a body-
guard, as it were, of admiring friends from among leading
representative Southerners made the trip with Mr. Grady for the
express purpose of hearing his exposition of the race problem.
Of Mr. Grady’s address there is nothing new to add. It was one of
the finest specimens of elegant and fervid oratory which this
generation has heard. It met the fondest anticipations of his friends,
and the people of his native State had planned to pay him
extraordinary honors for the surpassing manner in which he plead
their cause. The address, considered in all respects, was superior to
that which he delivered in New York and which won national
reputation for him. His treatment of the race problem was in no
respect new, and it met with only a limited approval, but while he did
not convince, Mr. Grady certainly won from the North a larger
measure of intelligent appreciation of the problem laid upon the
South. It was impossible not to perceive his sincerity, and we
recognized in him and in his address the type and embodiment of
the most advanced sentiment in the generation which has sprung up
at the South since the war. Mr. Grady’s father lost his life in the
Confederate army; Mr. Grady himself spoke in the North to Union
veterans and their sons. It was perhaps impossible, from the natural
environments of the situation, that he should speak to the entire
acceptance of his auditors, or that he should give utterance to the
ultimate policy which will prevail in the settlement of the race
problem. But we of the North can and do say that Mr. Grady has
made it easier for one of another generation, removed from the war,
to see with clearer vision and to speak to the whole country on the
race problem with greater acceptance than would now be possible.
To have done this is to do much, and it is in striking contrast with the
latter-day efforts of that other great figure in Southern life who has
but lately gone down to the grave unreconciled.
The North laments the death of Mr. Grady, and sincerely trusts that
his mantle as an apostle of the New South will fall upon worthy
shoulders. Business interests are bringing the North and South
together at a wonderfully rapid rate. This is not the day nor the
generation in which to witness perfect that substantial agreement for
which we all hope. But we are confident that if to the firmness of the
Northern views upon the civil rights of the black man there be added
a fuller measure of sympathy for those who must work out the
problem, and if Mr. Grady’s spirit of loyalty, national pride and
brotherly kindness becomes deeply rooted in the South, the future
will be promising for the successful solution of that problem which
weighs so heavily upon every lover of his country.
 A LEADER OF LEADERS.

From the “Philadelphia Times.”

The death of Henry W. Grady, chief editor of the Atlanta
Constitution, is an irreparable loss to the South. Of all the many and
influential newspaper men of that section, Mr. Grady can only be
compared with Mr. Watterson, of the Louisville Courier-Journal, in
point of distinction; and while Watterson is the better equipped
journalist, Grady was the greater popular leader. He was not only a
brilliant and forceful writer, but a most eloquent and impressive
speaker, and one of the most sagacious in council.
Mr. Grady was only ten years old when the civil war spread its
terrible pall over the land, and he was only a school-boy when his
native South was left defeated, desolated and despairing by the
failure of the Confederacy. He grew up with the new generation that
is so rapidly succeeding the actors of that great conflict in both
sections. He escaped the luxury and effeminacy of fortune; he had to
grapple with poverty amidst an almost hopeless people; and he was
one of the earliest of the new generation to rise to the full stature of
manly duty. Thoroughly Southern in sympathy, and keenly sharing
the memories which are sacred to all who wore and supported the
gray, he saw the new occasion with its new duties as the latent
wealth of the South, that so long slumbered under the blight of
slavery, gave promise of development; and alike in his own Empire
State of the South, and in the great metropolis of the Union and in
the Bay State citadel of opposite political views, he ever declared the
same sentiments and cemented the bond of common brotherhood.
And no other young man of the South gave so much promise of
future honors and usefulness as did Mr. Grady. He has fallen ere he
had reached the full noontide of life, and when his public career was
just at its threshold. He could have been United States Senator at
the last election had he not given his plighted faith to another; and
even with the office left to go by default, it was with reluctance that
the Legislature, fresh from the people, passed him by in obedience
to his own command. That he would have been leader of leaders in
the South, yea, in the whole Union, is not doubted; and he was the
one man of the present in the South who might have been called to
the Vice-Presidency had his life been spared. He was free from the
blemish of the Confederate Brigadier, that is ever likely to be an
obstacle to a popular election to the Presidency or Vice-Presidency,
and he was so thoroughly and so grandly typical of the New South,
with its new pulsations, its new progress, its new patriotism, that his
political promotion seemed plainly written in the records of fate.
But Henry W. Grady has fallen in the journey with his face yet
looking to the noonday sun, and it is only the vindication of truth to
say that he leaves no one who can fully take his place. Other young
men of the South will have their struggling paths brightened by the
refulgence his efforts and achievements reflect upon them, but to-
day his death leaves a gap in Southern leadership that will not be
speedily filled. And he will be mourned not only by those who
sympathized with him in public effort. He was one of the most genial,
noble and lovable of men in every relation of life, and from the
homes of Georgia, and from the by-ways of the sorrowing as well as
from the circles of ambition, there will be sobbing hearts over the
grave of Henry W. Grady.
 A FORCEFUL ADVOCATE.

From the “Springfield, Mass., Republican.”

The death of Henry Woodfin Grady, the brilliant young Southern
editor and orator, which took place at Atlanta, Ga., was almost tragic
in its suddenness; it will make a profound impression at the South,
and will be deeply deplored here at the North, where he had come to
be known as a florid yet forceful advocate and apologist of his
section. He had lately caught the ear of the country, and while his
speeches provoked critical replies, it may be said in his honor that
he, more than any other Southerner, had lifted the plane of sectional
debate from that of futile recriminations to more dignified and candid
interchanges of opinion. That is saying much for a man who was a
lad during the rebellion, and who had not passed his thirty-ninth
birthday. He was a man of pronounced views, perhaps given more to
pictures of prosperity than to the methods of its attainment, and
when upon the platform he carried the crowd by the force of that
genius for passionate appeals which his Irish ancestry and Southern
training had given him in full measure. No Southerner had put the
conflict of races in so reassuring a light; but he was not old enough
or far-seeing enough to realize that the problem can and will be
solved,—and that by Southerners.
Mr. Grady called about him a formidable group of young
Democrats filled with the spirit of the New South. They believed that
Georgia would rise and the South be reconstructed in the broadest
sense by the multiplication of factories and the advancement of
trade. These young men selected Gov. Colquitt for their standard-
bearer in the State election of 1880, and Mr. Grady was made
chairman of the campaign committee. Colquitt during his first term
had offended the Democratic regulars, and the young men carried
the war into the back country. The vote at the primaries was
unprecedentedly heavy. Colquitt carried the State and was the first
governor elected under the new constitution. Grady never held public
office, but it was supposed that he had been selected by the
Democratic leaders as Gov. Gordon’s successor, and many thought
that he was angling for the second place on the Democratic national
ticket in 1892.
The attention of the North was first called to the brilliant Georgian
by his address at New York in June, 1887, at the annual dinner of
the New England Society. His speech at the Washington Centennial
banquet last spring was rather a disappointment, but he fully
recovered his prestige the other day at Boston, where he shared the
honors of a notable occasion with Grover Cleveland. Mr. Grady
found time from his editorial work to write an occasional magazine
article, but his subject was his one absorbing study—the South and
its future.